Date of Conferral

7-24-2025

Degree

Ph.D.

School

Health Services

Advisor

Kristin Wiginton

Abstract

Cancer imposes a significant and multifaceted economic burden on California’s health care system and communities. Despite extensive national data, California-specific cost analyses have been outdated and limited. This study quantified California’s cancer-care burden through a quantitative, cross-sectional design grounded in the cost-of-illness framework and human-capital theory. A retrospective modeling approach used 2015–2023 data from the California Cancer Registry, National Cancer Institute, National Program of Cancer Registries, and California’s all-payer claims database. California’s economic burden from cancer was estimated using a meta-analysis of national cost data, which was then applied to state-specific cancer incidence, prevalence, and mortality through a multicriteria decision analysis framework. Historical costs were adjusted for inflation using the Medical Care Component of the Consumer Price Index. Parameter uncertainty was addressed with Monte Carlo simulations, and result robustness was evaluated through sensitivity analysis. Deterministic modeling estimated California’s 2023 cancer-related economic burden at $27.47 billion, including $24.27 billion in direct medical costs and $3.20 billion in productivity losses. Medicare incurs the largest share, followed by commercial insurance and Medi-Cal. Predictive modeling demonstrated that national burden indicators reliably forecast state-level economic impacts. California's composite cancer burden was estimated at 12.17% of the national total, resulting in projected costs ranging from $16.9 billion to $18.5 billion (F(1, 5) = 38.4, p = .002). The findings from this study provide evidence to inform efforts to reduce the economic burden of cancer, expand access to quality care, and address structural health disparities.

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